Mauritius: Fighting childhood malnutrition in Madagascar

Port-Louis, Mauritius (PANA) - Over 30 Malagasy and international scientists and clinicians are gathered at the Institut Pasteur de Madagascar, Antananarivo, Madagascar, Monday for the launching of the AFRIBIOTA project, an ambitious programme of multidisciplinary research meant to better understand chronic childhood malnutrition, PANA learnt from official sources.

In a dossier, obtained by PANA here, the Institut Pasteur de Madagascar said one child in four, aged under 5 in the world, suffer from malnutrition.

"Malnutrition is involved in almost half of infant mortality, more than 3 million children under age 5 each year. Malnutrition is also responsible for significant abnormalities of physical and mental development. Undernourished children have stunted growth, diminished cognitive performance and severe learning difficulties. Malnutrition thus feeds the vicious cycle of poverty by weighing heavily on the possibilities of social-economic development of future generations", it indicated.

Coordinated by Prof. Philippe Sansonetti, the ambitious research project proposes for the first time to address the Pediatric Environmental Enteropathy (PEE) syndrome in all its complexity by combining epidemiological, anthropological, biological, motor development and nutrition studies.

"The lack of food or inadequate nutrition practices are, however, not the only causes of undernutrition. In resource-limited countries, the deteriorated sanitary and hygiene environment continuously expose children to infectious agents. These permanently weaken the children’s immune systems and cause a chronic inflammation of the intestine", it indicated.

It is estimated that over 75% of children in developing countries suffer from this syndrome to various degrees. This syndrome, which disrupts the function of the intestine is recognized today as one of the major causes of malnutrition and is also associated with poor vaccine performance in children.

Despite its massive impact on child health, scientific data on PEE are scarce and there are no rapid and easy to use tools to diagnose it.

The programme that is supported by the Instituts Pasteur of Madagascar and of Bangui in collaboration with the National Office of Nutrition and the Malagasy Public Health Ministry will mobilize over 50 researchers, clinicians and health professionals de santé in a new multidisciplinary approach.

A diagnostic and epidemiological study carried out on 460 children in each country (100 are severely malnourished, 100 moderately malnourished and 260 having no malnutrition) will compare different PEE biomarkers in order to develop a diagnostic test easy to use in the field.

This study will also provide a first estimate of the number of children suffering from this intestinal inflammation in Madagascar and the Central African Republic.

A medical-anthropological study will analyze the dietary practices, hygiene, childcare, parental attitudes in case of illness, economic and political context to understand why some children develop PEE and some do not.

A study of the flora (microbiota) and the intestinal barrier will allow to better describe the biological alterations of the intestine due to PEE including chronic inflammation and possibly to identify new markers for this syndrome.

A study of psychomotor development will be conducted among all children enrolled in the study. Taking into account the cultural environment of the two partner countries, a standardized test will be developed to evaluate a set of criteria (language, motor skills, cognitive skills) and identify possible links between PEE, malnutrition and psychomotor disorders.

All the data obtained in the 4 studies will be compiled via mathematical modeling and thus will provide a holistic view of the syndrome as a basis to develop effective interventions for the benefit of children's health.